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171Click Here To Search Our Public Records Database Before Submitting Request Forms Can Be Submitted via Email to ],odellEt),LownofWappingeriiy.,ggv or ill person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590 FOR INTERNAL USE ONLY Received by: Joseph P. Paoloni Lynn O'Dell Lori McConologue Date Received: /_/_ FOIL Ser. 4: _ad,-) -�' _ I DEPARTMENT: ASSESSOR 17 ACCOUNTING Ll CODE ENFORCEMENT /744 PLANNING ZONING L. FIRE INSPECTOR HIGHWAY RECEIVER OF TAXES D RECREATION F1 SUPERVISOR Ll TOWN CLERK F1 WATER/SEWER F1 DOG CONTROL OFFICER L7 TOWN ENGINEER 11 TOWN ATTORNEY L Name: f� Address: Agency orfir rn: TOWN OF WAPPINGER Application for Public Access to R� ecords Received FOIL REO F17 'd AX 0 2 11 �3 BuHdhig Department Town of Wapp�nger FOR DEPARTMENT USE ONLY Date Received by Dept S_ / 2-D Department Head approval: A IQ (init) Date Applicant Contacted: a/ S / �P-3 Date FOIL fulfilled or denied: Closed by: Date: Notes: Oko'4� 4 j cc� Amount Due: Pages for a total of $ I .... .. .. . ....... . . . . . ...... . . . ...... Telephone #: q tL - 1%-9 FAX ##: Email address : -1 check here if you are requesting that the records be mailed to this address. SPECIFIC DESCRIPTION OF RECORD: --s V -1A '-ri - -_�'-7 .. . ........... . . ......... FORMAT OF RECORD (if available) F I request to be notified when I can come to inspect the record(s) described above L I request copies of the records described above and agree to pay the cost of such records in accordance with the fee schedule oil the back of this application L I request that the records be sent via e-mail to the address listed above F_ I request that the records be faxed to the number listed above